Hey, you! Mr. Spry Twenty-Five-Year-Old! Feeling pretty limber these
days, eh? Going out and CRUSHING beers
and playing campus golf and bending over to pick up entire crates of taco
meat. Life's pretty swell for you! Well, I have fun news for you, sport. PAIN
IS COMING. So much pain. One day, you will get out of bed, step wrong,
and you will fall apart like a fucking Russian hotel facade. You'll be lying on the floor and you'll be
thinking God, this really hurts. I may never walk again. Maybe I should kill myself. It happens that fast. Really just a matter of time for you!

This is a story about pain. If you've ever had it, maybe you'll feel compelled to read…
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It's a hard fact of life that most people, myself included,
never worry about health problems until they actually spring up. God knows how much money and pain we could
save this nation if we collectively decided to take more preventive health
measures, but that's not the way people work.
If I don't KNOW what kind of searing, jaw-clenching pain I'm in for,
well then I'm gonna go around juggling boulders and shoveling manure as I see
fit.

According to the American Chiropractic Association, 80% of
Americans will experience back pain in their lives. Having a bad back is so common that it's practically
a punchline at this point. It also
happens to be a misnomer. What people
really mean when they say they have a "bad back" is that they have a
bad spine, and having a bad spine sounds wayyyyyyy more serious. Your back is just a hairy, blotchy
thing. Your spine is the information superhighway
that takes information from your brain and trucks it out to the rest of your
body: VERY IMPORTANT. Saying you have a
bad back makes people think your suffering is confined to your back when really
a spinal disc problem can affect your legs, arms, hands, feet, and even your
bowel movements. Fun! It's curious that we've spent the past few
years fretting over brain injuries in the NFL, and yet no one blinks when Dez
Bryant plays through a "back injury," as if he can just throw some
Aspercreme on that shit and everything will be all right.

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In general, when your spine is fucked up, it's fucked up for
life. The damage caused by a
herniated disc is permanent. They can't
stuff the crabmeat back into the disc and stitch it up and make you good as
new. They either have to give you meds and
physical therapy to get rid of the pain, or remove part of the disc, or fuse
your vertebrae together in an operation you REALLY do not want (for your upper
spine, they cut through your throat; for your lower spine, they cut through
your tummy). Any of these methods can
help reduce your pain and suffering, but your body will never ever be the way
it once was. And the cruel part is that
once one part is damaged, other parts of your body must carry the burden and
sometimes also get damaged in the process.
It's just one long horrible parade of physical deterioration.

That is why I'm here to explain to all you cool kids out
there how to prevent the onset of Old Man Disease and take care of your
spine. I'm no doctor. I don't even like doctors because doctors are
mean and think they know every goddamn thing. But I've fucked up my back enough times and
stared at enough ceilings to learn a few things. And you'd best start taking care of yourself
right now, before everything goes to shit.
You don't want this. I promise
you. Here's what you can do to stop it:

1. Don't smoke. In addition to giving you lung cancer, mouth
cancer, tongue cancer, impotence, throat cysts, heart disease, stained teeth,
and that weird crinkly upper lip thing, cigarettes also murder your back. According to the National Institutes of
Health, smoking starves your disc cells of vital nutrients. Then those cells die and your discs fall
apart and you want to kill yourself.
It's as if they designed cigarettes specifically to cause your body
maximum damage. They may as well sell
you a box of knives to swallow. Anyway,
don't smoke. You probably knew this
already, but here's the millionth reason why.

2. You can bend. You can twist. You can lift.
But you can't do all three at once.
If you bend, twist and lift simultaneously, you're basically taking a
crowbar to your body. I know it's fun to
reach down to the left and pick up a medicine ball and then hurl it at your
frat bro's nuts, but do not do this. AND
DEFINITELY DO NOT DO THIS WHILE SMOKING.
I know there are fitness freaks out there who will tell you that doing
swinging dead lifts with 4,000-pound dumbbells is fantastic for your body. And it probably is, if you have world class
technique. But if you don't have world
class technique (and you won't), you will die.

3. Don't be fat. Being fat is great because you can eat a lot
and you get weird chafing burns in hidden places. But it turns out that enormous beer gut is
pulling your body down and forward at all times. Soon, your FUPA will drop all the way to the
floor and you'll have to grease it with vegetable oil in order to slide it down
the sidewalk. Everyone in America would
like to lose weight, and of course there are a million
ways to go about it. What works for
me (portion control, early dinner, exercise) may not work for you (deliberate
jaw wiring). The important thing is that
you find some kind of healthy lifestyle routine that you can tolerate. You don't have to like it. You probably won't. You just have to be able to tolerate it
enough to say yourself, "Hey, this isn't so bad. I can do this." If you write out a series of rules for
yourself and stick to them, you'll probably have a better chance of success.

I had terrible back pain and I needed to lose weight. I lost sixty pounds in five months. This is…
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It also helps to have an outside reason to lose weight. Saying you want to lose weight just to lose
weight is rarely enough motivation. Ah,
but if you say to yourself, "Hey, I'd like to lose weight so I won't be
crippled for life," then you might have a chance. Fatass.

4. Do yoga. It sucks.
I won't even pretend to tell you otherwise. It looks ridiculous. The music is goofy. And the stretches are AGONIZING. They look innocuous when you see other people
do them, but when you have to reach your arm up to the ceiling for longer than
half a second, you feel like you've been manacled in a Venezuelan prison camp. Even the breathing is hard. Ever inhale all the way? God, it's tiring. I don't need all that air. The first couple of times you try yoga, you will
yell out FUCK THIS and never want to do it again. It's also really annoying to see ex-gymnasts
nearby who can do all those poses effortlessly and can bite their own ankles
while you can barely touch your own knees.
Those people are awful. Also,
yoga is for GIRLS, and girls are so lame!

But... if you stick with it... if you grit your teeth and
get the hang of it, it eventually pays off.
You find out that you can move parts of your body that you didn't even
know you could move before. I have,
like, muscles in the back of my shoulders.
And they work! I didn't know that
before! It's a cliche to talk about
strengthening your core, but when that part of your body feels light and compact,
you move with much more confidence. I worry
about re-injuring my back about half as much as I did before trying yoga.

You can also do it without any of the meditation or mantra
stuff. This is the workout I do (link is
only to the first 10 minutes; you can buy the DVD at Amazon), but take a class
if you feel like you really need to get the technique down. Pilates also works.

5. Wear good shoes. You can tell when a dude has never had any
back problems because he'll freely walk around in some dirty-ass flip flops
with the heel worn down to nothing and his feet sliding off to the slide with
every step. You may as well not even
wear shoes at that point. Those things
are just foot luggage. Same with any
fancy-pants dress shoes made of Peruvian suede with a sole thin enough to jack
open a hotel room door. All hurtful. Any shoe that makes you look good will
probably end up handicapping you. What
you probably need is a pair of ugly-as-sin Merrell sneakers or some other shoe
designed for you to walk comfortably around the edge of a fucking volcano. When I used to try on shoes at the store, I
would do that thing where you put them on, take three steps, look at your feet
in the shoe bench mirror (looking good!), and then that's it. I can't do that anymore. I have to THINK about how the shoe
feels. I basically need hover shoes to
relieve all body pressure.

6. Don't sit. Sitting takes all the weight of your upper
body and places it squarely on your lower back, which is how you end up with
both back pain and the dreaded Office Ass (wide, flat, able to display IMAX
screenings of Gravity). And that's if you sit CORRECTLY, which most
people don't do. Most people sit hunched
over a laptop with their face close enough to the screen to lick it. That's like triple sitting damage. Back when we were cavemen or something, we
rarely sat. We stood and walked and
speared our food and all that, which is why you now see terrible people running
around in toe socks and swearing by the paleo diet. They are trying to create a reasonable
facsimile of that constantly active lifestyle.

You don't have to go THAT far, because then you'll look like
an idiot. But if you work in an office,
it might help to stand while you work.
You'll feel like a freakshow the first couple of days, but then you get
used to it. You don't have to buy some
zillion-dollar tread desk or anything.
You stack a chair on top of a table and place whatever screen you're
using at eye level (I stack a couple books on the chair to raise it up a bit),
with the keyboard at a comfortable height for your hands to reach. You'll be amazed at how tiring this is the
first time you try it (you'll have the same complaint as any waiter: "I've
been on my feet all day"), but you will eventually feel better. You won't leave work feeling like pale death. You'll feel more productive. And hey, Donald Rumsfeld worked standing and
everyone loved him!

7. If you have a
problem, make sure your doctor and/or physical therapist doesn't suck. When you're 24, you're basically picking a
doctor out of a hat. Are they nearby? Are they open? Does my company's garbage insurance cover 10%
of the cost?I'M ALL YOURS, DR. NICK. Frankly,
it can be hard to tell if a doctor is fucking terrible because most of them
SOUND like they know what they're doing.
Just remember that you're entrusting this person with your spinal cord. In some cases, you will even be allowing this
person to drill into your body next to that cord in an attempt to heal it.

So do the best research you can. Find the Yelp! of doctors ("They won't
take my Discover card!"), ask friends for recommendations, find out what
school your doctor went to. Make sure
he's not a knee guy moonlighting with your sciatic nerve. If you see a chiropractor (I don't go to
them), make sure he won't roll you over a metal garbage can.

And if you suspect that you HATE your doctor, have the courage
to seek out a second opinion, even when that means trudging to a whole other
office and doing even more goddamn paperwork and spending money you almost
certainly don't have. This is a
healthcare system that goes to great lengths to discourage you from seeking
options (the best doctors often opt out to the network entirely, which makes
them even more expensive), but do it if you can.

The doctor you see will probably tell you to get physical
therapy. Again, try to do your
homework. Make sure your PT has a recent
master's or a doctorate and that they're up-to-date on new techniques, like
trigger point dry needling (the pain lets you know it's working!). Don't go to some ancient joint that will hook
you up to a stim machine for twenty minutes and then send you on your way. This shit is constantly evolving and the best
PTs incorporate those newer methods as they turn up. And if they give you exercises for homework,
keep up with it. Even when they tell you
those exercises are for life. I remember
not being able to comprehend that the first time I heard it. "Like, I have do this forever?"

And usually, you do.
Such is the burden of walking around inside a human body. It's not a perfect thing and it gets less
perfect as time goes by. But if you put
in a relatively small amount of effort now, you may never have to learn how imperfect
it can get.